Fibromyalgia pain and substance P decrease and sleep improves after massage therapy.

Massage therapy has been observed to be helpful in some patients with fibromyalgia. This study was designed to examine the effects of massage therapy versus relaxation therapy on sleep, substance P, and pain in fibromyalgia patients. Twenty-four adult fibromyalgia patients were assigned randomly to a massage therapy or relaxation therapy group.

Rotational excitation of H2O by cold electrons.

Experimental data are presented for the scattering of electrons by H2O between 17 and 250 meV impact energy. These results are used in conjunction with a generally applicable method, based on a quantum defect theory approach to electron-polar molecule collisions, to derive the first set of data for state-to-state rotationally inelastic scattering cross sections based on experimental values.

Maternal psychological distress, prenatal cortisol, and fetal weight.

Objective: The objective of this study was to examine the effects of maternal psychological distress on estimated fetal weight during midgestation and explore the maternal hypothalamic-pituitary axis and sympathoadrenal dysregulation as potential risk factors for these effects.

Methods: Fetal ultrasound biometry measurements and maternal sociodemographic characteristics, emotional distress symptoms, and first morning urine samples were collected during a clinical ultrasound examination for a cross-sectional sample of 98 women who were between 16 and 29 weeks pregnant. Fetal weight was estimated from ultrasound biometry measurements; maternal emotional distress was assessed using the daily hassles (stress), Center for Epidemiologic Studies-Depression (depression), and State-Trait Anxiety Inventory (anxiety) scales; and urine samples were assayed for cortisol and norepinephrine levels.

Breast cancer treatment of older women in integrated health care settings.

Purpose: A substantial literature describes age-dependent variations in breast cancer treatment, showing that older women are less likely to receive standard treatment than younger women. We sought to identify patient and tumor characteristics associated with the nonreceipt of standard primary tumor and systemic adjuvant therapies.

Patients And Methods: We studied 1,859 women age 65 years or older with stage I and II breast cancer diagnosed between 1990 and 1994 who were cared for in six geographically dispersed community-based health care systems.

Expression, purification, crystallization and preliminary crystallographic analysis of BipD, a component of the Burkholderia pseudomallei type III secretion system.

A construct consisting of residues 10-310 of BipD, a component of the Burkholderia pseudomallei type III secretion system (T3SS), has been overexpressed as a GST fusion, cleaved from the GST tag and purified. Crystals were grown of native and selenomethionine-labelled BipD. The crystals grow in two different polymorphs from the same condition.

Anorexia nervosa symptoms are reduced by massage therapy.

Nineteen women (M age = 26) diagnosed with anorexia nervosa were given standard treatment alone or standard treatment plus massage therapy twice per week for five weeks. The massage group reported lower stress and anxiety levels and had lower cortisol (stress) hormone levels following massage. Over the five-week treatment period, they also reported decreases in body dissatisfaction on the Eating Disorder Inventory and showed increased dopamine and norepinephrine levels.

Design, synthesis, and evaluation of proline and pyrrolidine based melanocortin receptor agonists. A conformationally restricted dipeptide mimic approach.

The design, synthesis, and structure-activity relationships (SAR) of a series of novel proline and pyrrolidine based melanocortin receptor (MCR) agonists are described. To validate a conformationally constrained Arg-Nal dipeptide analogue strategy, we first synthesized and evaluated a test set of cis-(2R,4R)-proline analogues (21a-g). All of these compounds showed significant binding and agonist potency at the hMC1R, hMC3R, and hMC4R.

Patterns and predictors of mammography utilization among breast cancer survivors.

Background: Improvements in cancer detection and treatment have resulted in increasing numbers of breast cancer survivors. Information regarding the use of mammography by breast cancer survivors is limited.

Methods: The use of surveillance mammography was examined over a 5-year period in a retrospective cohort of women age>or=55 years who were diagnosed with incident primary breast cancer (1996-1997) while enrolled in 1 of 4 geographically diverse integrated health systems.

Prescribers' responses to alerts during medication ordering in the long term care setting.

Objective: Computerized physician order entry with clinical decision support has been shown to improve medication safety in adult inpatients, but few data are available regarding its usefulness in the long-term care setting. The objective of this study was to examine opportunities for improving medication safety in that clinical setting by determining the proportion of medication orders that would generate a warning message to the prescriber via a computerized clinical decision support system and assessing the extent to which these alerts would affect prescribers' actions.

Design: The study was set within a randomized controlled trial of computerized clinical decision support conducted in the long-stay units of a large, academically-affiliated long-term care facility.

Valganciclovir is safe and effective as pre-emptive therapy for CMV infection in allogeneic hematopoietic stem cell transplantation.

Despite significant advances in prevention and therapy, cytomegalovirus (CMV) infection continues to be an important cause of morbidity and mortality in the hematopoietic stem cell transplant (HSCT) recipient. The standard drug for pre-emptive therapy is intravenous ganciclovir (GCV). Valganciclovir (VGC), the oral pro-drug of GCV, has excellent bioavailability and is ideal for oral therapy.

Are matched unrelated donor transplants justified for AML in CR1?

There has been controversy about the optimal consolidation therapy for patients with acute myeloid leukemia (AML) in first remission. Hematopoietic stem cell transplantation from human leukocyte antigen (HLA)-identical siblings has improved the survival of patients with unfavorable cytogenetics, but has not improved the survival of intermediate- or favorable-risk patients. If an HLA-identical sibling donor is not available, alternative sources of stem cells may be sought.

Extraesophageal manifestations of gastroesophageal reflux.

Background: Associations have been reported between gastroesophageal reflux and a variety of upper and lower respiratory tract conditions. Respiratory conditions and GER are common and would be expected to coexist in many patients. Whether there is a relationship between GER and these conditions and its nature remain controversial.

The costs associated with adverse drug events among older adults in the ambulatory setting.

Background: Reducing the rate of adverse drug events in the ambulatory setting may require large investments in quality improvement efforts and technologic innovations. Little evidence is available on the potential resulting savings.

Objective: The objective of this study was to estimate the costs associated with adverse drug events among older adults in the ambulatory setting.

Disparities and survival among breast cancer patients.

Background: Although rates of survival for women with breast cancer have improved, the survival disparity between African American and white women in the United States has increased.

Purpose: To determine whether this survival disparity persists in an insured population with access to medical care.

Methods: In this retrospective cohort study, we extracted data from the tumor registries of six nonprofit, integrated health care delivery systems affiliated with the Cancer Research Network and assessed the survival of African American (n = 2276) and white (n = 18 879) female enrollees who were diagnosed with invasive breast cancer from January 1, 1993, through December 31, 1998.

Building a virtual cancer research organization.

Background: The Cancer Research Network (CRN) comprises the National Cancer Institute and 11 nonprofit research centers affiliated with integrated health care delivery systems. The CRN, a public/private partnership, fosters multisite collaborative research on cancer prevention, screening, treatment, survival, and palliation in diverse populations.

Methods: The CRN's success hinges on producing innovative cancer research that likely would not have been developed by scientists working individually, and then translating those findings into clinical practice within multiple population laboratories.

Building a research consortium of large health systems: the Cancer Research Network.

Critical questions about cancer prevention, care, and outcomes increasingly require research involving large patient populations and their care delivery organizations. The Cancer Research Network (CRN) includes 11 integrated health systems funded by the National Cancer Institute (NCI) to conduct collaborative cancer research. This article describes the challenges of constructing a productive consortium of large health systems, and explores the CRN's responses.

Effect of oxygen limitation on the in vitro antimicrobial susceptibility of clinical isolates of Pseudomonas aeruginosa grown planktonically and as biofilms.

Pseudomonas aeruginosa, the predominant causative pathogen of chronic lung infection in patients with cystic fibrosis, may grow under anaerobic conditions as biofilms in the lungs of cystic fibrosis patients. To determine if growth under anaerobic conditions affects the antimicrobial susceptibility of P. aeruginosa, the susceptibility of clinical isolates of P.

Computerized physician order entry with clinical decision support in the long-term care setting: insights from the Baycrest Centre for Geriatric Care.

Although computerized physician order entry (CPOE) has been successfully implemented in many acute care hospitals, few descriptions of its use in the long-term care (LTC) setting are available. This report describes the experiences of one LTC facility in developing and implementing a CPOE system with clinical decision support (CDS). Even when a facility has the necessary resources and "institutional will," many challenges are associated with the implementation of this application.

Cortisol decreases and serotonin and dopamine increase following massage therapy.

In this article the positive effects of massage therapy on biochemistry are reviewed including decreased levels of cortisol and increased levels of serotonin and dopamine. The research reviewed includes studies on depression (including sex abuse and eating disorder studies), pain syndrome studies, research on auto-immune conditions (including asthma and chronic fatigue), immune studies (including HIV and breast cancer), and studies on the reduction of stress on the job, the stress of aging, and pregnancy stress. In studies in which cortisol was assayed either in saliva or in urine, significant decreases were noted in cortisol levels (averaging decreases 31%).

Massage therapy for skin conditions in young children.

Two studies are reviewed that highlight the positive effects of massage therapy on skin conditions in young children. In the first study children being treated on a burn trauma unit received 30-minute massages before debridement or dressing change. The children who received massage therapy were more relaxed during the procedure.

Organizational barriers to physician participation in cancer clinical trials.

Objective: To assess barriers to physician participation in cancer clinical trials among oncologists, oncology leaders, and health plan leaders.

Study Design: Mail survey of 221 oncologists combined with semistructured telephone interviews with oncology and plan leaders at 10 integrated healthcare systems.

Methods: The survey instrument examined physicians' involvement in clinical trials; their perception of the value of trials to them, their patients, and their organization; and the presence of infrastructure support for trials and associated resource constraints.

Vagal activity, gastric motility, and weight gain in massaged preterm neonates.

Objective: Multiple studies have documented an increase in weight gain after 5 to 10 days of massage therapy for preterm neonates. The massaged preterm neonates did not consume more calories than the control neonates. One potential mechanism for these effects might involve massage-induced increases in vagal activity, which in turn may lead to increased gastric motility and thereby weight gain.

Selection of unrelated donors for hematopoietic cell transplantation.

Transplants from partially human leukocyte antigens (HLA)-incompatible relatives are associated with an increased risk of graft rejection, graft-versus-host disease (GVHD), and lower survival, which are correlated with the degree of disparity. For patients without an HLA-matched sibling, the preferred donors of hematopoietic cells remain HLA-compatible, unrelated volunteers. The hurdle for a wider application of hematopoietic cell transplantation is the enormous polymorphism of HLA genes that makes unrelated individuals unlikely to match randomly.